Foote Health System serves more than 247,000 individuals throughout six Michigan counties. In January 2005, FHS and Jackson Physicians Alliance, a 160-member physician contracting group, joined together to champion a community electronic health record by forming Jackson Community Medical Record LLC. JCMR selected and implemented of a fully integrated HIPAA-compliant EHR hosted on an application service provider. The shared database enables providers to leverage the work of each other. The community is already experiencing the benefits of the HER, including increased accuracy of medications, patient satisfaction, efficiency and reimbursement. The JCMR business model provides low entry costs and economies of scale. Software licenses and services are negotiated and held by JCMR. The interfaces between hospital systems and providers are maximized. JCMR is successfully bringing isolated islands of patient data together and serves a model for other communities.